TURNIP HOLE, Pa. (EYT) – It’s a long road from Turnip Hole (near Knox) to Walter Reed National Military Medical Center, but when Occupational Therapist Kristi Say served there for six years as a civilian employee, her patients almost seemed worlds away.
Now, an occupational therapist for Clarion Forest VNA, Say proudly remembers her work with injured soldiers and amputees from the Iraq and Afghanistan at Walter Reed.
“Everybody thinks that it must be a hard and depressing job, but it’s exactly the opposite,” said Say. “They were inspiring every day. They’re getting prosthetics, walking, and learning to do things. It was great because in rehab you were able to give them all of that and help them.”
Say graduated from Keystone High School and then earned her Occupational Therapy degree from Gannon University in Erie. Her first job was at Health South in Harrisburg and worked three years with strokes and head injuries and then three years with pediatrics before the chance to serve at Walter Reed.
At Gannon, she was paired with someone who would become her best friend as a freshman.
“She was also in the ROTC program, and she was automatically commissioned in the Army,” said Say. “When I was working in Harrisburg, she was stationed at Walter Reed. She called me one day and said, ‘Listen we are just getting annihilated with all of these amputation patients from Operation Iraqi Freedom. We could use the help, and you’re off on Fridays.’ I said, ‘I can’t; I’m licensed in Pennsylvania, and I can’t come there.’ She said, ‘It is the Military, and there are ways.'”
It was culture shock when she agreed to come down to Washington, D.C. for a weekend. Walter Reed was the primary hospital for amputees and served active duty military, families, and veterans.
“I went down on my first Friday and was totally overwhelmed,” continued Say. “You come up to your post, and there’s a guy standing there with an M-16, and you’re searched when you get out of your car. I asked what am I getting myself into?”
When she walked into the hospital and her duty area, the first thing she noticed were about 20 amputee patients sitting there with two therapists working with them.
“I learned very quickly that the military is ‘trial by fire.’ It’s roll up your sleeves, dig in, and go to town. After I had gone down three times, the Colonel asked me if I could come down and work with them if he was able to get a civilian position.
Say decided it was a great opportunity, and she wanted a one-year contract. She ended up spending six years at Walter Reed.
Throughout Afghanistan and Iraq campaigns, there were more amputations than in earlier years and wars. In fact, many soldiers did not make it with these types of injuries.
“We are proud to say with the advancements in medicine and the military, we would get these guys back within 24 or 48 hours of their injury. That was just unheard of in past wars. By the time I left, we had eight quadruple amputees.”
From injury on the field, they would be immediately sent back to their Forward Operating Base and then sent to Landstuhl, Germany, and then to Walter Reed. Many times the therapists were the first to see the new arrival.
“Psychology was a large part of it,” said Say. “As you can imagine, anyone who one minute would be sitting with their buddies in a Humvee, and the next minute they wake up stateside in Walter Reed missing two legs and an arm. They almost have to get over the psychological thing before they can get on with physical recovery. Maybe 15 to 20 percent of wounded were females.”
Patients were all ages, but it was predominately 18 to 35 years old. Civilian contractors who were working for U.S. also arrived because suicide bombers do not target one individual, and everybody is at risk.
The first thing
Some questions have to be answered when therapy starts.
“The first thing for therapy is they have to figure out if they want to stay in or get out,” said Say. “Around 26 percent stayed in, and not all of those folks are going back to their same assignment. If you stay in, you have to pre-qualify to shoot an M-16, to tear it down, to tear down a 9 millimeter. With a prosthetic arm — are you able to shoot in prone, can you shoot in a lane or standing, can you run six miles with an 80-pound pack? There were a lot of components if they wanted to stay in.”
However, if the soldier was going to leave the military, they faced the question of what they were going to do with the rest of their life. Even little things like making a resume and other questions are involved in the process.
The lengths of stays for patients are varied. Civilians would stay one to two months, but military patients could stay several years because their “duty” station was transferred to Walter Reed.
“If they are getting out, they finish their career there,” said Say. “They have to go through all of the Med boards and red tape process. We saw them every single day for one or two years.”
Say said, “One of the advantages of working with the military was they were able to beta test all of the new prosthetics. I’m sure things have changed quite a bit since, and now they have the Luke Skywalker arm and are doing even different things like integrating the prosthetic with the bone. There are amazing advancements being made.”
Politicians
Appearances by various politicians were also part of the Walter Reed scene.
“I have met more politicians, and the presidents came, and that was a circus in itself,” said Say. “It was almost like the entire post closed on days when President Bush or President Obama came. It was interesting because I was always curious of the folks that were there genuinely and sincerely and wanted to sit and talk with the guys versus the people that were advised to be there and shake a hand. You could tell: it was pretty apparent.”
When to leave
Say knew it was time to change jobs and maybe move closer to home after talking with one patient.
“I had a 19-year-old from Brooklyn who would cry and beg me every morning to kill him,” explained Say. “He would say Kristi I just can’t do this. After five days, I hit my breaking point, and I walked back into the clinic and the Colonel’s office and shut the door. I started crying that I love the job, but I am done.”
Say gave a six-month notice to help train her replacement, but they tried to encourage her to stay and just take the weekend and think about it. Her mind was made up. Military personnel is rotated every two to three years, but civilian employees provide continuity and have longer stays.
Using her six-month notice as a chance to job search, she first took a home health job in Butler, and a few years later she took advantage of a job opening with the VNA, and she has been there for three years.
“I’m the field staff occupational therapist and go out to the homes of folks who sustained an injury or have an illness and getting them back to independence,” said Say. “The focus of home health and the VNA is to keep people in their home forever and make sure they are as safe and independent as possible.”
The first question she gets from her older clients with the VNA is the need for an occupational therapist.
“The first thing you get is ‘Hey I’m 83, and I don’t need a job, and I retired a long time ago.’ It’s more the occupation of living. If you have a stroke, now you have to know how to dress, how to get out of bed, how to get off the toilet, out of the shower, getting your meals, and driving are all part of occupational therapy.”
Say enjoys her job and readily admits that the contrast between Walter Reed and the VNA are night and day, but she draws on experience from all of her jobs and her education.
“We learned in college about the Cultures of Self,” said Say. “I learned very quickly how to deal with individuals and different personalities, and you can apply that to whatever population you’re working on a job. Some of the people I see are old and cranky and grumpy, so you have to change your personality to fit that. Some people are very upbeat, and it was the same thing with the patients at Walter Reed.”
“With some of the people you had to draw a hard line, and you had to be that drill instructor, but other people you had to be that nurturing mother. I’ve learned a lot of things in each job that I’ve had and carry it over to the next job.”
Say is glad to be back home and recently built a home on property near the family farm in Turnip Hole.
She still keeps in touch with her friends at Walter Reed and likes the contrast between there and home. She sent them a photo of a traffic jam in Knox – An Amish buggy was slowly moving on the road.
